Point of Care Officer

Al Rajhi Takaful; Riyadh; On-site; SAR 67,000 - 112,000; Full time

Job summary

Al Rajhi Takaful in Riyadh is seeking a dedicated customer service professional to serve as the contact point for members and providers. You will handle inquiries in person, by phone and email, ensuring timely follow-up and resolution in line with company standards.

Responsibilities include surveying clients and providers, analyzing feedback, coordinating with networks, and supporting reporting and policy verification throughout the member journey.

Qualifications

• Diploma degree in insurance, Healthcare management, or related fields is required.

Responsibilities

• Serve as point of contact for members and providers, handling inquiries in-person, by phone and email.
• Conduct surveys to monitor client and provider satisfaction.
• Analyze feedback trends and suggest recommendations for service enhancements.
• Document and analyze recurring provider and client issues to address root causes and improve service processes.
• Coordinate with providers, members and internal teams to resolve service issues and ensure smooth operational support.
• Support the review of healthcare provider network by collecting and updating relevant provider information.
• Prepare and present accurate reports to support management decisions and fulfill reporting requirements.
• Verify members' health insurance policies and provide guidance throughout the process including admissions, medical and lab requirements, radiology and claims.
• Establish and maintain relationships with providers and insurance directors through visits to support and enhance partnership framework.
• Support Point of Care operations and handle operational cases generated from assigned sites and network hospitals.
• Adhere to service procedures and maintain knowledge of departments, provider networks and company services.
• Resolve member complaints effectively within delegated authority to ensure satisfaction.

Education

Diploma in Insurance

Diploma in Healthcare Management

Job description

Job Purpose

To serve as a point of contact for members and providers by handling inquiries in-person by phone and email in accordance with company standards ensuring timely follow-up and resolution that meets the expectations of members providers and internal teams while supporting high-quality service delivery

Key Activities Responsibilities and Accountabilities

• Conduct surveys to monitor clients and providers satisfaction
• analyze feedback trends and suggest recommendations for service enhancements
• Document and analyze recurring provider and client issues to address root causes and improve service processes
• Coordinate with providers members and internal teams to resolve service issues and ensure smooth operational support
• Support the review of healthcare provider network by collecting and updating relevant provider information
• Prepare and present accurate reports to support management decisions and fulfill reporting requirements
• Verify members health insurance policies and provide guidance throughout the process including admissions medical and lab requirements radiology claims etc
• Establish and maintain strong relationships with providers insurance directors through regular front-line visits addressing concerns and feedback and promoting a positive provider image to support and enhance the partnership framework
• Support Point of Care operations and handle operational cases generated from assigned sites and network hospitals
• Adhere to service procedures and maintain in-depth knowledge of departments provider networks and company services to handle member inquiries confidently and accurately
• Resolve member complaints effectively within delegated authority to ensure satisfaction with minimal need for escalation

Job Requirements

Academic Qualifications and Experience : Diploma degree in insurance, Healthcare management, or related fields is required. 0-2 years of related experience.